Misoprostol and Illegal Abortion in Fortaleza, Brazil
Coelho, Helena Lutescia Luna
Teixeira, Ana Claudia
Santos, Ana Paula
Forte, Eliane Barros
Morais, Silvana Macedo
La Vecchia, Carlo
Lancet. 1993 May 15; 341(8855): 1261-1263.
Misoprostol, a prostaglandin analogue indicated for ulcer treatment, has been widely used as an abortifacient by women in Brazil, where abortion is legal only in cases of rape or incest, or to save the woman's life. Because misoprostol is an inefficient abortifacient, many women who use it have incomplete abortions and need uterine evacuation. We reviewed the records of women admitted to the main obstetric hospital of Fortaleza, capital of Ceara state, Brazil, between January, 1990, and July, 1992, for uterine evacuation after induced abortion. The number of incomplete abortions induced by misoprostol increased substantially during the first half of 1990, and declined thereafter. Of the 593 cases in 1991, 75% were related to misoprostol...The number of uterine evacuations per month fell from 89 in August, 1990, to 62 in July, 1991, when sales of misoprostol in Ceara state were suspended. The fall continued after the sale of misoprostol ceased, to about 20 cases in December, 1991; numbers remained around this level until June, 1992, sustained by clandestine sales. The lack of access to contraception is the main reason for the large numbers of unplanned pregnancies and is a major public health issue for Brazilian women. The prohibition of abortion creates a void in which misuse of medicines is one extra complication, mainly because of the poor control of drug marketing.
Abortion; Congenital Disorders; Contraception; Drugs; Females; Fetuses; Government; Government Regulation; Health; Health Care; Health Care Delivery; Hospitals; Illegal Abortion; Incest; Induced Abortion; Life; Marketing; Morbidity; Patient Care; Patients; Public Health; Rape; Records; Regulation; Risks and Benefits; Self Care; Statistics; Survey; Women's Health;
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